关于胃癌吐的TTD专家共识:基于证据的预防和治疗策略
Ana Fernández Montes1, Ismael Macías Declara2, Nieves Martínez Lago3
1Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Calle Ramón Puga Noguerol 54, 32005, Ourense, Spain. afm1003@hotmail.com.
概括
在胃癌 (GC) 患者中,管理吐至关重要. 指南建议量身定制的抗组合和非药物战略,以改善生活质量.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 支持性护理是一种支持性护理.
背景情况:
- 胃炎是胃癌 (GC) 患者常见的并发症,影响高达70%的人,并显著损害生活质量.
- 原因包括瘤进展 (例如,胃出口阻塞,胃) 和抗瘤疗法 (化疗,放射治疗,向疗法) 的不良影响.
- 恶心和吐等症状可能导致脱水,营养不良,疲劳和心理困扰 (焦虑,抑郁).
研究的目的:
- 为胃癌患者的吐管理提供共识指南.
- 突出多学科和个性化方法的重要性.
- 强调基于证据的治疗算法,以有效的症状管理.
主要方法:
- 对抗吐预防的国际指南 (ASCO,ESMO,MASCC,NCCN) 的审查.
- 考虑病因因素:与瘤相关的机制和抗瘤治疗风险.
- 药理学策略 (抗-5-HT3,德克萨米他,抗NK1,奥兰zapine) 和非药理学干预措施的整合.
- 根据治疗的嘔吐风险和患者特征 (年龄,性别,药物基因组学) 量身定制预防.
主要成果:
- 建议使用组合抗emetic疗法,包括5-hydroxytryptamine 3型受体对抗剂 (anti-5-HT3),德克萨米他和神经素-1受体对抗剂 (anti-NK1).
- 偶尔可能会使用olanzapine.
- 预防需要基于个体患者因素和治疗风险的个性化.
- 非药物干预是药物治疗的必要补充.
结论:
- 在GC中有效管理吐需要多学科和个性化的方法.
- 基于证据的治疗算法对于优化抗策略至关重要.
- 量身定制的药理和非药理干预措施改善了患者的结果和生活质量.
更多相关视频
相关概念视频
Gastroesophageal Reflux Disease II: Clinical Features and Management
218
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
218
Barrett Esophagus-II: Clinical Manifestations and Management
315
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
315
Prevention of Further Absorption of Poison
931
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
931
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
329
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
329
Gastritis III: Clinical Manifestations and Management
493
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
493
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
265
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
265


